Active NPI
Tatiya Gelean Maddox, RN
- Nurse Practitioner
- New Orleans, LA
National Provider Identifier
1619717907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN270384
- Practice address
- 1900 Gravier St
New Orleans, LA 70112-2262 - Phone
- (504) 568-4106
- NPI assigned
- May 25, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN270384 | GA | Primary |
Addresses
Primary practice location
1900 Gravier St
New Orleans, LA 70112-2262
Mailing address
2608 Highland Ave SE
Smyrna, GA 30080-2145
Phone (678) 428-5226
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN270384 | GA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716595200000",
"number": "1619717907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2608 HIGHLAND AVE SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300802145",
"telephone_number": "678-428-5226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 GRAVIER ST",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701122262",
"telephone_number": "504-568-4106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADDOX",
"first_name": "TATIYA",
"middle_name": "GELEAN",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-25",
"last_updated": "2024-05-25",
"certification_date": "2024-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "RN270384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Orleans, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.